SUSAN CAROL BRACK - Dentist License in Illinois | # 020001697

SUSAN CAROL BRACK

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020001697

License Status

NOT RENEWED

Business

N

First Name

SUSAN CAROL

Last Name

BRACK

Business Name

SUSAN CAROL BRACK

Original Issue Date

07/13/1972

Effective Date

07/13/1972

Expiration Date

09/30/1984

State

IL

Ever Disciplined

N

LastModifiedDate

10/12/2005